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RACGP re-emphasises general practice’s mental health role


Matt Woodley


4/10/2021 5:08:43 PM

GPs have the skills and capacity to deliver mental health care, but require support to integrate these services a college submission states.

GP mental health consultation.
Around 87% of MBS-supported mental health specific care was delivered by GPs in in 2018–19.

The RACGP has responded to the draft National Mental Health Workforce Strategy (NMHWS) by highlighting the central role GPs have in providing mental health care in Australia.
 
The college’s submission to the NMHWS Taskforce points out that more than 10% of the population received MBS-supported mental health specific care in 2018–19, and that 87% of these services were provided by a GP.
 
It also explains how these figures likely under-represent the ‘true magnitude’ of GP mental health presentations, as longer mental health consultations in general practice do not have a specific MBS item number and are therefore often billed as a general consultation.
 
To better support the work of GPs in this space, the college has called for the integration of mental health care into primary care as a ‘cost-effective solution’ for preventing and managing mental health illnesses in Australia.
 
‘Primary care-led mental health services will help address issues early and keep patients out of the hospital system at a much lower cost to all levels of government and patients,’ the submission states.
 
‘General practices have the skills and capacity but require support to integrate services.’
 
To help improve the quality of Australia’s mental health care system, the college has advocated for the development of GP psychiatry career pathways, such as those used for GP obstetrics and GP anaesthetics. It has also called for comparable remuneration structures to support uptake.
 
‘This investment is especially important since there are shortages of psychiatrists and other health professionals that provide clinical mental health services, especially in rural and remote areas,’ the submission states.
 
‘General practice is the most accessible service for those who require mental health care and, in rural areas, often the only service available.
 
‘It is important to emphasise that any investment in a GP psychiatry career pathway should not detract from efforts to support and encourage all GPs to provide high quality mental health care within the scope of general practice.’
 
About 90% of GPs have completed RACGP-managed accredited Mental Health Skills Training and approximately 1200 GPs have completed the more specific Focussed Psychological Strategies (FPS) training.
 
Aside from improved access in remote and regional areas, the submission contends that people who may not otherwise have contact with the healthcare system – such as Aboriginal and Torres Strait Islanders or people from culturally and linguistically diverse backgrounds – are also more likely to have contact with a general practice than other mental health care providers.
 
Likewise, the use of telehealth – including telephone consultations – for mental health services could reduce distance and cost barriers that prevent people from seeking appropriate mental health support.
 
‘Mental health services provided via telehealth, including telephone, is shown to have the same level of effectiveness as face-to-face consultations in achieving improved health outcomes,’ the RACGP submission states.
 
‘Embedding changes to the MBS to enable telehealth consultations between a patient and their regular GP and for GP after hours attendances will help to address gaps in access to community healthcare.’
 
Consultation on the draft NMHWS ended on 30 September and a final report is expected by the end of 2021.
 
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Dr Henry Arthur Berenson   5/10/2021 2:42:27 PM

Unfortunately reality has bypassed the RACGP. GPs are got allowed to treat ADHD. We have to wait until our patients get to see a specialist. A diagnosis of PTSD is not recognised by the NDIS unless it is made by a psychologist. Last time I looked at the DSM , the diagnosis does not require great expertise, well within the capacity of a mere GP and does not warrant further accreditation of our skill set